CMS Price Transparency Data

CT scan, sinuses

Facility: East Morgan County Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $561
  • Cash Discount Price: $720
  • vs. Medicare Baseline: 5.25x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at East Morgan County Hospital is $561. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $720. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.25x the Medicare baseline. Located in 2400 W Edison St, Brush, CO.
Cash / Self-Pay
$720

Average discount available for prompt cash payment at this facility.

Insurance Median
$561

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)
Cash / Self-Pay: $720 (674%)
Insurance Median: $561 (525%)
Cash: $720 (674% of Medicare)
Ins. Median: $561 (525% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 525% of the Medicare baseline (a markup of 425%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Aetna $38 - $2,284 36%
Banner Health $38 - $1,056 36%
Blue Cross Blue Shield $38 - $1,850 36%
Clear Spring Health $38 - $1,056 36%
Healthspring Life & Health Insurance Company, Inc. $38 - $1,056 36%
Medica $38 - $2,046 36%
Medicare (plans) $38 - $1,056 36%
Pinnacol Assurance Workers Comp $38 - $1,035 36%
Triwest Healthcare Alliance Corp - Va Ccn $38 - $1,056 36%
UnitedHealthcare $38 - $2,284 36%
Longevity $39 - $1,088 37%
Humana $41 - $1,119 38%
Devoted Health Services $42 - $1,162 39%
Assist Health Group $46 - $1,267 43%
Denver Health Medical Plan $71 - $1,965 66%
Apostrophe, Inc. $80 - $2,210 75%
First Choice Health Network $80 - $2,210 75%
Hue Health, Inc $85 - $2,333 80%
Rocky Mountain Health Plans $85 - $2,333 80%
Multiplan $86 - $2,382 81%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2400 W Edison St, Brush, CO 80723
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals